Pathology of the Liver 1 Flashcards
What are the stages of pathogenesis for liver disease?
insult to hepatocytes
inflammation
fibrosis
cirrhosis
What is the definition of acute liver failure?
acute onset of jaundice/ development of hepatic encephalopathy 2-3 weeks after the first symptoms of hepatic insufficiency
Causes of acute liver failure
- viruses
- alcohol
- drugs (paracetamol overdose)
- bile duct obstruction
What is jaundice?
yellowing of the skin due to the build up of bilirubin
Pre hepatic jaundice occurs due to..
increased haemolysis, which means levels of unconjugated bilirubin are raised
Causes of pre hepatic jaundice
haemolytic anaemia, haemolytic disease of the newborn, Gilbert’s syndrome
What is Gilbert’s syndrome?
increased levels of unconjugated bilirubin, hereditary
What is hepatic jaundice?
damage to hepatocytes, resulting in increased conjugated and un conjugated bilirubin
causes of hepatic jaundice
alcoholic hepatitis
cirrhosis
pregnancy
bile duct loss
what is post hepatic jaundice?
bile cannot pass into the bowel or biliary tree, so leaks into the circulation
symptoms of post hepatic jaundice
dark urine, pale faeces
what causes post hepatic jaundice?
gallstones of CBD
strictures of CBD, e.g due to surgery
congenital biliary tree atresia
tumours of the head of the pancreas
what is Cirrhosis?
irreversible change to the liver, where bands of fibrosis separate the regenerative nodules of hepatocytes
complications of cirrhosis
portal hypertension
spider naevi
ascites
LIVER FAILURE
how to diagnose cirrhosis?
LFTs
Ultrasound
CT
causes of cirrhosis
alcohol hepatitis B/C gallstones Wilson's disease autoimmune diseases
Three types of portal hypertension
prehepatic - blockage of portal vein before the liver
hepatic - disruption/change of liver architecture
posthepatic - blockage in the venous system after the liver
Complications of portal hypertension
oesophageal varices
ascites
splenomegaly
dilatation of anastomoses between systemic and portal system
Alcoholic fatty liver features
occurs after a short binge
fat accumulates in hepatocytes
reversible
alcoholic hepatitis features
occurs after weeks-months inflammation necrosis pericellular fibrosis mallory bodies reversible
alcoholic fibrosis features
months-years
collagen lay down around cells
alcoholic cirrhosis features
irreversible
bands of fibrosis separate regenerative nodules
What is non alcoholic fatty liver disease?
- build up of fat in hepatocytes, pathology is same as alcoholic liver disease
Who gets NAFLD?
- occurs in individuals who do not drink alcohol
- obese
- diabetics
- hyperlipidaemia
